physician ‘alignment’ achieving cultural synergy in the pursuit of clinical excellence...

Physician ‘Alignment’Achieving Cultural Synergy in the Pursuit of Clinical Excellence

Mississippi Healthcare Executives Summer MeetingJune 5 & 7, 2013

Mark Williams, MD, MBA, JDChief Medical Officer

Leadership

Knowledge Management

Customer Focus

Strategic Planning

Workforce Focus

Process Management

Results

An atmosphere of mutual respect,

transparency and learning

‘As health care evolves, mutually productive physician relationships are critical . . . what are additional opportunities?’

Adapting to New Payment

Models

Providing More Coordinated

Care

Eliminating Avoidable

Harm

Embracing Evidence-Based

Care

Improving Efficiencies

Extensive Professionalization

Strong Personal Bonding

Focus on IndividualsCollegial RelationshipsSuspect of ‘outsiders’

On the front-lines‘Now’

Less Professional Support

Focus on PopulationsShared ResponsibilitiesFew Patient EncountersMust Prioritize Issues

Need to Manage Politics

The Culture ‘Gap’

Healthcare ExecutivesPhysicians

A Unified Culture That Leverages Respective Strengths

To Achieve Superior Results

1937

The Commonwealth Fund

A Legacy of Community

The ‘Competent’ Community• Collaborates effectively in identifying

problems• Achieves a working consensus on goals• Agrees on means to implement the

agreements• Collaborates effectively in the agreed

actionsVaughn L. Grisham, PhD

A Legacy of Leadership Development

Lead

ership 2000

LMS C

lass M

anag

er

MVV as

Lead

ership Core

CARES LDI

QED

Shining S

tars

PLI 2010

70

74

78

82

86

90

1996

2010

19982000 2002 2004

20062008

EOS Survey Results

The Opportunities• Physician Leadership Institute• Physician Peer Review• Co-Management • Comprehensive Unit-Based Safety Program• Continuing Medical Education• Strategic Planning

‘Designed to serve North Mississippi’s partner physicians by providing innovative leadership training, personal development and practical management/strategic planning skills sets’

NMHS Physician Leadership Institute, 2011

Builds Upon the Leadership Development Institute• Leadership training is part of the culture• Significant investments

• Specific Selection Criteria• Commitment Well-Defined• 40 Class Hours• 60-80 Out-of-Class Hours• Support of Group• Expectations Clear• Honesty• Respect• Active Participation• Future Leadership Role

PhysiciansTime

HomeworkPI Project

Future Leadership

OrganizationTop LeadersPreparation

TransparencyMaterials, Meals

Mutual Obligations

• Materials provided by organization

• Wide range of topics• Correlated with lecture

series

Servant Leadership

Finance/Operations

Medico-Legal

Strategic Planning

Crucial Conversations

EXCELPerformance Management

LEAN

PI

• CEO as ‘lead-off’• Focus on Servant Leadership

PI Projects - Examples

‘Tell me where you need me’

‘Will there be follow-up classes for alumni?’

‘Hope this organization will view this group as a source for leadership’

Employed Private

PLI Participation – Gathering Steam!

2011

2012

2013

2%

5%

8%

Physician Peer Review

• Multi-disciplinary• Training for new members• Multi-year commitments• ‘No Blame’ approach• Administration Participation

Co-Management

• Embraces ‘accountable care’ concepts• Initial project – partnership with cardiologists• Joint management of cardiac ‘cath’ lab• Thorough ethical, financial and legal analysis• Model for other service lines

• Fixed Fee• Manages lab operations• Provides strategic planning• Staff development• Public relations• Vendor and payer issues

• Performance Fee• Employee satisfaction (5)• Patient satisfaction (5)• Quality component (30)• Cost savings (60)

https://oig.hhs.gov/fraud/docs/advisoryopinions/2012/AdvOpn12-22.pdf

Baseline Result0

0.5

1

1.5

2

Percutaneous Coronary Interven-

tion Complications (%)

Baseline Result0

500

1000

1500

2000

2500

Supply Costs ($) Aligned Incentives

CostQualityService

Comprehensive Unit-Based Safety Program

• Physician champions• Annual Culture of Safety Survey• Goal is broad expansion of the CUSP concept • Goal of safest system in U.S. by 2015

Quality of Care Initiatives

Baseline Q2 Q4 Q6 Q80

5

10

15

20

25

30

Sepsis mortality rate (%)*

*Unadjusted

Continuing Medical Education

• Physician lead program• Needs-based content• ‘In-house’ expertise• Region-wide audience

Future Challenges – We’re all at the Table

“The problem with health care today is people like me – doctors (mostly men) in our fifties and beyond . . .now, at many health care institutions and practices, we are in charge . . . and that’s a problem . . .”

Thomas Lee, MD, Turning Doctors Into LeadersHarvard Business Review, April 2010

(President, Partners HealthCare System)

Or, maybe, they’re partners in seeking solutions!Physician Leadership Institute, NMHS

• Chief of Surgery• Medical Staff President• Chief of Medicine• Chairman of IRB• CUSP Advocate

Influence beyond numbers!

Thank you for allowing us to participate in the summer

ACHE event

North Mississippi Health Services